Individual
MICHAEL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 RICHMOND RD N, BEREA, KY 40403-8788
(859) 986-4710
Mailing address
124 HAWTHORNE LN, GREENWOOD, IN 46142-9430
(317) 332-9861
(317) 893-4453
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
006907
KY
225100000X
Physical Therapist
Primary
05012352A
IN
Other
Enumeration date
03/19/2017
Last updated
04/24/2020
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